Reforming Healthcare Reform

I watched the healthcare vote on C-Span. I was disappointed in how partisan the vote concluded. Quality healthcare for all will undoubtedly not be the result of Sunday night’s vote. Quality care for all means that the breadth of who is covered is matched with the kind of care that compels foreign nationals from around the world to fly to the Johns Hopkins Hospital or the Mayo Clinic. Balancing these two dynamics of care without bankrupting the nation is a victory that every American would celebrate.

Because of partisanship, some of the most pressing problems in our national healthcare industry have not been addressed. Further, there are many unintended consequences that could plague the nation for years included in this measure. In his victory speech, the president made the statement that this bill was an example of “government of the people, by the people, and for the people.” Nothing could be further from reality. One party has imposed its will on the nation.

The administration's messaging around healthcare reform has often deepened the sense of mistrust and division between each one of us and our neighbors. For example, the healthcare debate has revolved more around our concerns about race and class in America than patient care. The “fat cats” have been repeatedly referred to. The underlying narrative has been that it’s time for the “haves” to sacrifice in order for the “have-nots” to obtain a government-controlled healthcare.

It seems that the administration has donned its Robin Hood outfit, deciding to make a moral statement about the value of the poor instead of digging deeply into substantive improvements of the world’s most celebrated healthcare system. As a result, most of my black, Hispanic, and paternalistic liberal friends have supported this measure. This support has been very strong despite the fact that bloating the system could produce patient complications or death. Without appropriate planning and structures - delay, denial, or rationing of services will undoubtedly result. The administration's need to force a political decision has obviously been more important to them than truly improving our healthcare system. From my perspective, as a survivor of a near terminal bout with cancer, this law needs to be more than a self-serving, public relations measure.

Many of our legislators did not read the measure in depth. Both they and the public have had to form opinions based on “second hand information” or promises. It is clear that the legislation has been shrouded in secrecy and political infighting. Further, the last minute negotiations that led to the bill's passage were based on questionable compromises (such as the Presidential/ Stupac deal). Therefore, many of us have been reduced to asking ourselves one question: “Do we trust the government or the president to deliver effective healthcare, despite our national history with entitlements and government managed programs?”

I am personally outraged at the duplicity and “hard ball” politics that have marked the Democratic Party’s approach to one of this decade’s most important issues. Healthcare policy outcomes will be very important for all Americans, especially minorities in the years to come. Minorities, who top the charts in terms of mortality from America’s most serious diseases, often do not realize that they have been used as pawns in the healthcare debate. Without the cooperation of both the Congressional Black Caucus and the Congressional Hispanic Caucus, there would have been no possibility of the bill passing.

In order to win these and other constituencies, the race and class cards have been played simultaneously in a de facto manner. Many opponents to healthcare have been demonized and labeled racists because they have voiced legitimate concerns with process, philosophy, and practicality of the proposed reforms. In this debate, most Americans have been guilty of thinking about their own personal needs, instead of what’s best for the nation.

In recent days I was shocked at the desperate twist the healthcare debate took. The suggestion that Nancy Pelosi and company wanted to use the “Slaughter Rule” was a sign that they had abandoned the realm of principle and genuine problem solving. Machiavelli’s “prince” had been reborn. Instead of becoming instruments of moral activism, they entered the moral “nether world” of prevarication, manipulation, and endless campaigning.

Cynicism and paternalism were at the root of their “take no political prisoners” approach to the law. As an African American, what disappointed me the most was that the administration presented itself as a transcendent step toward a new American experience. Instead we have perhaps stepped into a time warp that has given us the worst of politics-as-usual.

Aren’t there any good points to the law? Yes. The positives are threefold:

* No more rejections of individual coverage on the basis of pre-existing conditions * No more ability for insurance companies to arbitrarily increase premiums * Greater access to preventive care

Conversely, the administration’s healthcare plan is flawed on several levels: 1.) moral - its approach to the unborn 2.) administrative - it will result in rationing of care 3.) support of the medical community - 46% of doctors vow to quit if it passes 4.) cost - the nation cannot afford doing this all at once 5.) ideology – the government cannot manage healthcare better than a free, but monitored, market

In conclusion, I believe America needs healthcare reform. It is obvious that greater accessibility, affordability, portability, and lower costs are needed. Nonetheless, how we manage this move will make all the difference in the world. Today, historic changes in healthcare have occurred. No one knows whether we are primed for long-term blessing or disaster. This is a textbook case of doing the right thing the wrong way.